Pulmonary hypertension is high blood pressure that is exclusively in the lungs. It is not to be confused with general hypertension, which is high pressure in the arteries. Exposure to burn pits or Agent Orange has been linked to pulmonary hypertension. If you believe your pulmonary hypertension was caused by your time in service, we can help you figure out if you have a service connection and be eligible for VA disability compensation benefits.
In this article about VA benefits for Pulmonary Hypertension:
- What is Pulmonary Hypertension?
- Causes of Pulmonary Hypertension
- Group 1: Pulmonary Arterial Hypertension (PAH)
- Group 2: Pulmonary Hypertension caused by Left-Sided Heart Disease
- Group 3: Pulmonary Hypertension caused by Lung Disease
- Group 4: Pulmonary Hypertension caused by Chronic Blood Clots
- Group 5: Pulmonary Hypertension Triggered by Other Health Conditions
- Burn Pits and Pulmonary Hypertension
- Typical Pulmonary Hypertension Symptoms
- How is it Diagnosed?
- Is There Treatment for Pulmonary Hypertension?
- Related Conditions
- Can I Be Rated for General Hypertension and Pulmonary Hypertension?
- Permanent and Total Rating for Pulmonary Hypertension
General hypertension, also known as high blood pressure or systemic hypertension, is pressure in the arteries that is higher than it should be. Pulmonary hypertension only occurs in the lungs and can exist in a person that does not suffer from general hypertension.
With pulmonary hypertension, the blood vessels in the lungs can become stiff, narrow, or damaged, and the right side of the heart must work harder than normal to pump blood through. There are five groups of pulmonary hypertension, depending on the cause. We’ll go through each of these groups below.
A study found that veterans are more likely to suffer from pulmonary hypertension due to the stress of being on active duty. Therefore, it is important to know what pulmonary hypertension is and how you can get VA disability benefits for it.
The five groups of pulmonary hypertension are as follows:
In this group, causes include:
- Heart problems present at the time of birth (congenital heart disease)
- A genetic mutation passed down through families (heritable pulmonary arterial hypertension)
- Use of illegal drugs like methamphetamines and other drugs or use of some prescription diet drugs
- Unknown cause (idiopathic pulmonary arterial hypertension)
- Other conditions like HIV, chronic liver disease (cirrhosis), and connective tissue disorders (lupus, scleroderma, others)
This group has two main causes: left-sided heart valve disease, such as aortic valve or mitral valve disease and failure of the lower left heart chamber (left ventricle).
The causes of this group include:
- Obstructive sleep apnea
- Chronic obstructive pulmonary disease (COPD)
- Long-term exposure to high altitudes in people who may be at risk of pulmonary hypertension
- Pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs’ tiny air sacs (interstitium)
One of our VA disability lawyers talks about how veterans with lung conditions get permanent ratings in this video.
The two main causes within this group are chronic blood clots in the lungs (pulmonary emboli) and other clotting disorders.
Sometimes other health issues can cause pulmonary hypertension and those include:
- Kidney disease
- Inflammatory disorders like vasculitis and sarcoidosis
- Metabolic disorders, including glycogen storage disease
- Tumors pressing against pulmonary arteries
- Blood disorders, including essential thrombocythemia and polycythemia
In this video, one of our VA disability lawyers talks about disabilities caused by burn pits used in Iraq and Afghanistan.
There has been evidence suggesting that burn pits used by the U.S. Military can cause lung conditions that lead to pulmonary hypertension. Smoke from these burn pits contained toxic substances that traveled into living areas on military bases. Exposure to burn pits has also been linked to many other diseases, so check out the list of presumptive conditions caused by burn pits.
Just recently, asthma has been made a presumptive condition of burn pits. Since asthma has been proven to make pulmonary hypertension worse, the service-connected asthma from burn pits could help you prove a service connection for PH. Every combination of lung conditions is different, but as congress rules that a condition like asthma is a presumptive disability, other conditions are easier to prove also.
Burn Pit Presumptive Conditions List
As more veterans develop symptoms caused by burn pit exposure, the VA is building their list of presumptive conditions for disability ratings.
Typical Pulmonary Hypertension Symptoms
Symptoms of pulmonary hypertension are not evident until the condition has progressed. The first noticeable symptom is usually shortness of breath with everyday activities like climbing stairs. Fainting spells, fatigue, and dizziness could also be early symptoms.
As the strain on the heart increases, more symptoms such as chest pain, swelling in the ankles, abdomen, or legs, and bluish skin and lips are noticeable. Any given patient may not have all these symptoms and any of these symptoms can be mild to life-threatening.
In more severe cases of this disease, even light activity can produce some of these symptoms. Additional symptoms include:
- Dizziness or passing out
- Irregular heartbeat (strong, throbbing sensation or palpitations)
- Difficulty breathing at rest
- Racing pulse
- Progressive shortness of breath during exercise or activity
The heart has two lower chambers (ventricles) and two upper chambers (atria). Every time blood moves through the heart, the lower right chamber (right ventricle) pumps blood to your lungs via a large blood vessel called the pulmonary artery.
In the lungs, the blood releases carbon dioxide and receives oxygen. The blood normally flows easily through blood vessels in the lungs (pulmonary arteries, capillaries, and veins) to the left side of the heart.
However, changes in the cells that line the pulmonary arteries can cause the artery walls to become thick, stiff, and swollen. These changes may slow or block blood flow through the lungs, causing pulmonary hypertension.
Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.
Pulmonary hypertension is often hard to diagnose, so a specialist is sometimes required for an accurate diagnosis. Even when it is more advanced, the symptoms and signs are similar to those of other lung and heart conditions.
A doctor will perform a physical exam and ask about the symptoms you are experiencing. You will also need to answer questions about your medical and family history. If your doctor suspects you might have pulmonary hypertension, you will have to do one or more preliminary tests. These tests include:
- Chest X-rays
- Blood tests
- Electrocardiogram (ECG)
- Nuclear scan (ventilation/perfusion scan or V/Q Scan)
- Exercise tolerance test (six-minute walk test)
- Pulmonary function tests
If your results point to pulmonary hypertension after some preliminary tests, your doctor will perform a right-heart catheterization. This is the only test that directly measures the pressure of the pulmonary arteries, and it should be done at least once to confirm a diagnosis of pulmonary hypertension.
Once you receive your diagnosis, you will be classified based on the severity of your pulmonary hypertension.
|Class Number||Qualifications of Class|
|Class I||You have been formally diagnosed with pulmonary hypertension, but you have no symptoms with normal activity|
|Class II||You do not experience symptoms at rest, but you have symptoms such as fatigue, chest pain, or shortness of breath with normal activity|
|Class III||You are comfortable at rest but have symptoms when you’re physically active|
|Class IV||You have symptoms at rest and while doing physical activity|
Here is a video of one of our Veterans Disability Lawyers teaching you how to use our VA Disability Combined Ratings Calculator.
Unfortunately, there is no cure for pulmonary hypertension. However, you can get prescribed treatments to help manage your condition. The focus of treatment is to improve symptoms and slow the progression of pulmonary hypertension. Finding the right treatment can take time, so don’t lose hope if finding treatment takes longer than expected.
Medications for Pulmonary Hypertension
There are several medications available to treat pulmonary hypertension. Here is the list:
- Endothelin receptor antagonists
- Blood vessel dilators (vasodilators)
- High-dose calcium channel blockers
- Guanylate cyclase (GSC) stimulators
- Oxygen therapy
- Sildenafil and tadalafil
Surgery for Pulmonary Hypertension
If medications are unable to provide relief from pulmonary hypertension symptoms, surgery may be required. There are three surgeries available:
- Transplantation. In some cases, a heart-lung or lung transplant may be an option, especially for younger patients who have idiopathic pulmonary arterial hypertension.
- Atrial septostomy. This is an open-heart surgery that relieves pressure on the right side of the heart. This surgery can have serious complications like heart rhythm problems (arrhythmias).
- Pulmonary thromboendarterectomy. During this procedure, blood clots in the pulmonary artery are surgically removed to improve lung function and blood flow.
If you get diagnosed with pulmonary hypertension, you could be at risk to develop the following conditions:
- General hypertension
- Pulmonary embolism
- Arrhythmia (irregular heartbeats)
- Right-sided heart enlargement and heart failure (cor pulmonale)
- Blood clots
- Bleeding in the lungs
Pulmonary Embolism vs Pulmonary Hypertension
Pulmonary embolism and pulmonary hypertension are often confused. In some cases, pulmonary embolism can cause pulmonary hypertension. The good news is that both conditions are eligible for VA disability benefits.
Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. It usually occurs when a blood clot breaks loose and travels through the bloodstream and lands in the lungs. This can be life-threatening, especially if the clot is large or if there are many free-floating clots. Pulmonary embolism is a serious condition that can cause low oxygen levels in the blood, damage to other organs from not getting enough oxygen, and permanent damage to the lungs.
The VA disability ratings for pulmonary embolism are rated under Diagnostic Code 6817 for Pulmonary Vascular Disease and they are as follows:
|VA Rating||Description of Rating|
|0%||No symptoms are present following the resolution of a pulmonary thromboembolism|
|30%||You experience some symptoms following the resolution of acute pulmonary embolism|
|60%||If you experience chronic pulmonary thromboembolism that requires anticoagulant therapy, or; following inferior vena cava surgery without evidence of pulmonary hypertension or right ventricular dysfunction|
|100%||If you have primary pulmonary hypertension, or; chronic pulmonary thromboembolism with evidence of pulmonary hypertension, right ventricular hypertrophy, or cor pulmonale, or; pulmonary hypertension secondary to other obstructive diseases of pulmonary arteries or veins with evidence or right ventricular hypertrophy or cor pulmonale|
General hypertension is when blood vessels have consistently high pressure. If your blood pressure reading is 140/90 or above, you most likely have high blood pressure. However, there are high blood pressure VA disability benefits available. The VA rates hypertension from 10% to 60%.
A 10% rating is granted when your diastolic pressure is 100 to 109, or your systolic pressure is 160 to 199. A 20% rating is when your diastolic pressure is 110 to 119, or your systolic pressure is 200 or higher. A 40% rating is given when your diastolic pressure is 120 to 129, and finally, a 60% rating is granted when your diastolic pressure is 130 or higher.
Diastolic pressure means the pressure of blood against arteries in between heartbeats. A normal diastolic pressure reading is usually between 80 and 90. Systolic pressure refers to the pressure of blood against arteries during each heartbeat. A normal systolic pressure reading should be below 120.
Pulmonary hypertension is high blood pressure specifically in your lungs, however, you can suffer from both general hypertension and pulmonary hypertension.
Pulmonary fibrosis is scarring of the deep tissue in the lungs. This tissue becomes stiff and thick, making the breathing process very difficult. As a result, your blood may not get enough oxygen and you can experience worsening shortness of breath.
You can also get a VA disability rating for pulmonary fibrosis, but not for both pulmonary hypertension and pulmonary fibrosis because the VA limits ratings for overlapping symptoms. These two conditions are very different but can be confused because of the similar names.
Yes, you can receive a rating for your general hypertension and your pulmonary hypertension. It is important to note that if you have multiple lung conditions, avoidance of pyramiding will come into play so you don’t get two ratings for overlapping symptoms. So, if you are rated for your pulmonary hypertension, you cannot be rated for that and asthma. The VA is supposed to give you the rating for whichever condition has the higher rating. If your asthma would earn a higher rating than you’re pulmonary hypertension, you would get a VA rating for asthma and not PH.
If your pulmonary hypertension is bad enough that you can’t work, you could be placed in the Total Disability Individual Unemployability range if your combined ratings are high enough. You would need at least one of your ratings to be 60% or more, or have at least two service-connected disabilities, one rated at least 40% with a combined rating of at least 70% or more. You also have to prove you cannot hold down a steady job.
Veterans who can’t hold down a steady job that supports them financially (known as substantially gainful employment) because of their service-connected disabilities are eligible for TDIU if they have:
- At least one service-connected disability rated at 60% or more disabling OR
- Two or more service-connected disabilities with at least one rated at 40% or more disabling and a combined rating of 70% or more
Since pulmonary hypertension is often chronic, it may be eligible for a permanent and total rating. Chronic diseases are often eligible for a permanent and total rating, which means a veteran can have a disability that is either 100% disabling (total) and/or will not improve throughout their life (permanent).
To find out if you can receive VA disability benefits for your pulmonary hypertension, give us a call today at 800-544-2108 or fill out our online contact form. Here at Woods and Woods, we will never charge you for help with an initial claim, we only charge if we win your appeal. We have helped thousands of veterans across the nation get the benefits they deserve. See if we can help you today.
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VA Disability Lawyer
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Talk to Us About Your Claim:
General Hypertension is on the Agent Orange presumptives list, but pulmonary hypertension is not. If you have a service connected lung condition, talk to your doctor or call us to see how we can prove to the VA that it was caused by Agent Orange.
Hypertension, or general hypertension happens all over your bodyand can affect numerous organs. Pulmonary hypertension occurs only in the lungs and only has a direct effect on your heart.